Provider Demographics
NPI:1700887593
Name:STARKEY FAMILY PRACTICE CLINIC
Entity Type:Organization
Organization Name:STARKEY FAMILY PRACTICE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TUTUT
Authorized Official - Middle Name:ARIANI
Authorized Official - Last Name:STARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-965-2005
Mailing Address - Street 1:789 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KY
Mailing Address - Zip Code:42064-1858
Mailing Address - Country:US
Mailing Address - Phone:270-965-2005
Mailing Address - Fax:
Practice Address - Street 1:789 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KY
Practice Address - Zip Code:42064-1858
Practice Address - Country:US
Practice Address - Phone:270-965-2005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000343501OtherBLUE CROSS BLUE SHIELD
KY1957301Medicare PIN
KY000000343501OtherBLUE CROSS BLUE SHIELD